Diabetes Type II Care and Management - Term Paper Example

Diabetes type 2 An assignment submitted by Spring Diabetes type 2 Purpose Diabetes Type 2 is a metabolic diseases caused by problems in theproduction of the hormone insulin and the resultant high-blood sugar or glucose levels. It leads to number of serious health ailments. So, it becomes significant on the part of the patients to understand what causes this disease and how they should adopt lifestyle changes and follow medications to manage it. So, this booklet will help the patients to understand Type 2 diabetes, medications options to treat it, an idea about best and worst foods choices, how to prevent the threat of infections, and physician follow-up. All these details are given below, reading which, will provide a clearer insight about the disease to the patients thereby increasing their awareness about it and also how to effectively manage this serious ailment. DM type 2 Unlike the people who suffer from type 1 diabetes, who does not at produce insulin, people with type 2 produce insulin but might not make adequate insulin or the body cannot use it well enough to manage blood sugar levels (called as insulin resistance). When the pancreas does not produce the required levels of insulin to manage the glucose, the resultant increase can enter your body cells leading to host of problems. As far as insulin resistance is concerned, insulin will not be able to play its role properly because the body’s cells remain unaffected by it (“The importance of monitoring blood-glucose levels,” n. d). Diabetes Type 2 and the resultant high blood sugar can cause series of ailments including heart disease, kidney failure, stroke, diabetic retinopathy affecting eyes, poor blood flow to the legs leading to amputations in certain cases, others. This presents a grave scenario for the patients. At the same time, although, there is no permanent cure for this type 2 diabetes, it can be managed by eating aptly, exercising, and through medications or insulin therapy. Medication Administration Some patients suffering from type 2 diabetes will be able achieve their target glucose levels through apt diet management and effective exercise alone, however, majority of the sufferers will need oral diabetes medications or injection-based insulin therapy. The best suitable medication would differ from patient to patient because it depends on the individuals’ blood sugar level, their response to the initial treatment, other health problems, and so on, with doctors even prescribing a combination of drugs from different classes. In that direction, doctors are prescribing a combination of metformin and glyburide to help body cope up with high glucose levels. Glyburide, belonging to a class of drugs called sulfonylureas, facilitates the pancreas to release more insulin into the bloodstream and decrease the amount of sugar the liver makes. On the other hand, Metformin decreases sugar release and its absorption by stomach and intestines (“Glyburide and Metformin (Oral Route),” n. d). This combination medication has to be taken orally along with meals, which is a key point to be noted for patients. To reduce any risk of side effects, including low glucose levels and upset stomach, doctors might also suggest initiating this medication at a lower dose and then gradually increasing the dose. The efficacy and the safety of this metformin and glyburide combination in treating type 2 diabetes are being studied through various lab studies. Chen et al. (2007) evaluated whether this combination works better than taking metformin and glyburide individually or separately. A 16-week, multicenter, randomized clinical trial study was conducted with 100 patients having type 2 diabetes mellitus. These patients were divided into groups, with one group having the combination drug, the other group having metformin, one another having glyburide only, with the fourth group put under placebo treatment. At the end of the 16 weeks, Chen et al (2007) came to the conclusion that glyburide/metformin combination therapy were efficacious and well tolerated, when Chinese patients with type 2 diabetes mellitus was treated with it thereby showing its efficacy (Chen et al., 2007). In the earlier times, insulin therapy was suggested by the doctors as the last resort, but nowadays it is being prescribed sooner because of the benefits it gives over the above-discussed oral medications. It gets absorbed by the blood quickly and so it shows immediate results, and because of that insulin is mainly injected. Insulin cannot be taken orally because the digestive chemicals in the stomach and intestine can destroy it. So, it would better if you inject insulin in abdomen, upper outer arms (not into muscle parts), buttocks, and upper tights, with abdomen being the most preferred site as there will be stable absorption of insulin there. Speaking of insulin therapy, there are number of insulin administration regimes, with Sliding Scale being one of them. Patients reading this booklet may have a misconception that this scale might have a physical object to slide or something like that. However, it does not have any such thing and instead it is a chart which tells you how much of insulin you should inject at meals depending on your blood sugar levels. To use this scale, you need to first check your blood glucose levels before meals. So, before delving further regarding the sliding scale, it is important to know how to check your blood sugar levels in your homes. It can be checked using small portable equipment called a blood glucose meter along with other related tools. Firstly, you need to prick your finger using a small, sharp needle known as a lancet, and then place the resulting drop of blood on a given test strip. This test strip has to be then inserted into the meter and in less than 15 seconds the meter will not only provide the levels but can also store this information for future use. As above-mentioned, when you are following the Sliding Scale regime, the blood sugar levels have to be tested before meals. After checking the levels, you have to look at the chart and find the corresponding amount of insulin you have to inject. The amount of insulin slides up and down (increases or decreases) in conjunction with the direction your glucose levels slides, with lower amounts of glucose necessitating less insulin, while greater amounts more. Kramer, Zinman & Retnakaran (2013) identified about 1645 studies which were published between 1950 and Nov 19, 2012, which assessed the effect of intensive insulin therapy on type 2 diabetes patients. The results of their study showed that insulin therapy can improve the underlying pathophysiology in early type 2 diabetes mellitus, thereby providing a effective treatment strategy (Kramer, Zinman & Retnakaran, 2013). Diet management: 10 good food choices Whole-grain flours, including whole wheat flour Whole grains that includes brown rice Baked sweet or white potato Corn, popcorn or products made from corn Vegetables such as broccoli, cauliflower, and carrots Lettuces, greens, kale, spinach, arugula Beans and lentils Nuts Fish, particularly mackerel, sardines, salmon and pilchards Greek Yoghurt (“Best and Worst Foods for Diabetes,” n. d) 5 food choices to avoid White flour Processed grains including white rice Avoidance or cutting down on the fat, particularly saturated fats Reducing salt intake, limiting to 6 g or less a day Drinking alcohol in moderation (Theobald, 2014) Importance of glucose monitoring and normal values Correct and constant monitoring of blood glucose is a key responsibility for any type 2 diabetes patients. You should check your blood glucose levels as often as you need to, and as recommended by your doctor. The main reason why it is crucial is because you may not exhibit any overt symptoms or ill-health because of type 2 diabetes, unless you experience hyperglycaemia, which happens when the blood-sugar level is too high, or on the other end, hypoglycaemia, which happens when the blood-sugar level is too low. Both these conditions can lead to serious repercussions including unconsciousness, falls, stroke, heart attack, and others. So, to avoid both these serious eventualities, you have to constantly monitor you blood glucose levels through self-testing tools. Infection prevention Diabetes can impair your body’s ability to withstand and fight infection. That is, increased glucose levels in your blood and thereby body issues can facilitate growth of bacteria thereby causing quick spread of infection. Some of the common sites of infection are your bladder, kidneys, vagina, gums, feet, and skin (Dansinger, 2015). The symptoms or signs you need to look for when your bladder, kidneys or vagina is infected are constant fever of over 101 F, chills, vaginal itching, painful urination, cloudy or foul smelling urine, and others. When your skin is infected, particularly with sores on your limbs, you have to look for signs such as skin rashes, tenderness, redness, or swelling around the sores, non-healing sores, and others. When your mouth, particularly gum, is infected, the signs to look out for are sore throat, persistent cough, pain when swallowing, sinus drainage, headaches, white patches in your mouth or on your tongue, and others. When infection is not eliminated and spreads, it can lead to even graver problems such as amputation of limbs when wounds in the limbs do not heal quickly and spreads. So, it becomes crucial to treat infections very early in order to prevent more serious complications. Importance of physician follow-up care You require effective physician follow-up care. You have to schedule regular appointments with your physician at intervals which he/she suggests. Apart from the general physician, you also need to consult specialists regularly. That is, you have to make sure you see an eye doctor every year, your dentist twice a year, and other specialists who can help you maintain your good health (“Follow-up Care,” n. d). When you carry out this follow-up care, physicians can provide you a good picture of how you are managing you condition, whether anything needed to be corrected, how long the medication need to be continued, and others. References “Best and Worst Foods for Diabetes.” (n. d). In WebMD. Retrieved from http://www.webmd.com/diabetes/diabetic-food-list-best-worst-foods Chien, H. H., Chang, C. T., Chu, N. F., Hsieh, S. H., Huang, Y. Y., Lee, I. T.,... Sheu, W. H. (2007). “Effect of glyburide-metformin combination tablet in patients with type 2 diabetes.” Journal of the Chinese Medical Association 70 (11), 473-80. Dansinger, M. (2015). Diabetes and infection. Retrieved from http://www.webmd.com/diabetes/guide/infections-linked-diabetes “Follow-up Care.” (n. d). In Lehigh Valley Hospital. Retrieved from http://www.lvhn.org/conditions_treatments/diabetes/type_2_diabetes/overview/follow_up _care “Glyburide and Metformin (Oral Route).” (n. d). In Mayo Clinic. Retrieved from http://www.mayoclinic.org/drugs-supplements/glyburide-and-metformin-oral- route/description/drg-20061991 Kramer, C., Zinman, B & Retnakaran, R. (2013). Short-term intensive insulin therapy in type 2 diabetes mellitus: a systematic review and meta-analysis. Retrieved from http://download.thelancet.com/flatcontentassets/landia/pdfs/S0898589813000028.pdf “The importance of monitoring blood-glucose levels.” (n. d). In Brunet. Retrieved from http://www.brunet.ca/en/advices/the-importance-of-monitoring-blood-glucose- levels.html Theobald, M. (2014). The best and worst foods for type 2 diabetes. Retrieved from http://www.everydayhealth.com/health-report/managing-type-2-diabetes/best-and-worst- foods.aspx Read More